'I saw food as the enemy': radio host Katherine Dines

For years, Katherine Dines kept her eating disorder buried beside memories of the painful childhood episodes that triggered it.

“I pretty much buried it for most of my life,” says Dines, a popular radio host at Ottawa radio station Majic 100, and the mother of two teenaged girls.

Dines struggled with anxiety, depression and anorexia while growing up in Fredericton. Her mother died when Dines was an infant — from an undiagnosed heart condition — and she was raised in a home she describes as “physically and emotionally abusive.”

All of it led to an eating disorder that gave her the power to exert control over one aspect of her life: her body. Yet even when she weighed as little as 80 pounds, Dines did not admit she had a serious illness.

“I saw food as the enemy,” she remembers. “So I landed in hospital multiple times dealing with issues where I’d just, I’d literally stop eating. I’d drink water. I’d get really sick … But I didn’t see it as a disease.”

The problem recurred in her adulthood in response to emotional turmoil. She was hospitalized while at Belleville’s Loyalist College after a relationship fell apart, and again after the end of her marriage in 2003.

Using cognitive behavioural therapy, however, Dines has confronted the childhood trauma at the root of her illness, and identified the emotional triggers that can cause a relapse.

“I still go through phases, but the more I talk about it, and the more I own it, the more it helps me,” she said in a recent interview. “Because I feel like I’ve been hiding from it for so long, pretending it didn’t exist.”

Dines is now speaking publicly about her anorexia to raise awareness and to make it easier for others to talk about their struggles with eating disorders. “I don’t want anyone to be afraid to talk about it,” she says.

Dines is one of at least 600,000 Canadians with an eating disorder — illnesses that, activists say, have been buried too long from public consciousness, marginalized and misunderstood.

Anorexia is among the eating disorders described in the DSM-5, the American Psychiatric Association’s authoritative guide of mental disorders. For those diagnosed with the disease, food gets caught up in an unhealthy response to emotional problems.

“I think there’s a general lack of understanding,” says Wendy Preskow, founder of the National Initiative for Eating Disorders.

Preskow launched the coalition in 2012 as she watched her daughter, Amy, struggle to find appropriate treatment for anorexia nervosa and bulimia nervosa — eating disorders complicated by her clinical anxiety. Amy Preskow, now 31, was once sent home by a doctor who told her to “just eat”.

Another time, paramedics who responded to her collapse called her case “a waste of time” after learning she had an eating disorder.

“The attitudes towards her have been abominable,” says Wendy Preskow.

Severe eating disorders, Preskow says, are among the most lethal diagnoses known to psychiatric medicine, yet treatment options remain limited and wait times lengthy.

According to a 2014 House of Commons standing committee report, anorexia has the highest mortality rate among mental illnesses: It’s estimated that 10 to 15 per cent of those diagnosed with the condition will die from it — as many as 1,500 Canadians every year.

But Preskow says the health care system and research funding agencies do not treat the disease with commensurate seriousness.

“Eating disorders have always been low down on the totem pole,” she says. “We want to see them given the same respect, funding and research as every other mental illness. Right now, that gap is huge.”

In Ontario, she says, there are only 20 beds (including six in Ottawa) for adult in-patient treatment programs. The Ontario Shores Centre for Mental Health Sciences in Whitby offers the province’s only residential treatment program for adolescents.

The eating disorders coalition has asked the federal government to launch a national strategy on eating disorders to ensure early diagnosis and treatment; to improve data collection and research; and to better educate Canadian health care professionals about the disease.

The Liberal government of Prime Minister Justin Trudeau is negotiating a new health accord with the provinces that is to improve mental health services, but it’s not yet known whether that agreement will specifically address eating disorders.

Dr. Leora Pinhas, physician lead of the eating disorder residential program at Ontario Shores Centre for Mental Health Sciences, says her patients continue to suffer from the social stigma attached to the disease.

That stigma, she says, is pervasive even among health care workers, who regularly ignore the needs of those with eating disorders, or worse, blame them for not curing their own ailment.

“There’s this idea somehow that they’re manipulative, they’re horrible people, they’re doing it on purpose. These are all untruths. These are all myths,” says Pinhas, a psychiatrist and the founding president of the Eating Disorders Association of Canada.

“They are trying their damnedest. People don’t understand it’s an illness that affects brains. It’s not logical, but it’s not purposeful.”

Treatment can be complicated by other mental illnesses, such as depression or anxiety, or by childhood traumas. But adolescents treated in a timely fashion by trained clinicians make a full recovery about 70 per cent of the time, Pinhas says.

The problem is that there’s not nearly enough trained clinicians or quality treatment programs to meet the demand, Pinhas says. Her own centre, for instance, which treats the most severe eating disorder cases in the province, has a three- to four-month waiting list.

“I watch kids die because they can’t get adequate services,” Pinhas says. “And I think we should be ashamed of that.”

In Ottawa, both the Children’s Hospital of Eastern Ontario and The Ottawa Hospital have eating disorder programs that serve the region.

Dr. Hany Bissada, director of the program at The Ottawa Hospital, says there are months’ long waiting lists for both the six-bed in-patient program and for the day program, which can accommodate eight people. A medically compromised patient with advanced anorexia will typically require eight to 10 weeks in hospital.

Bissada says a national strategy to improve services for those with eating disorders is desperately needed.

“There’s a misperception, even among family physicians, that this is a self-induced problem, and that we shouldn’t waste our resources on something you are doing to yourself, that if you eat, you’ll be fine,” Bissada says.

“It is a superficial mentality because if a patient could go home, eat and be fine, they would have done it long ago. Anytime they try to eat, they are paralyzed by fear. This is the nature of the illness.”

At CHEO, the eating disorder program for adolescents has a wait list of up to three months, although patients who are medically unstable are admitted to the hospital immediately.

Eating disorders predominantly affect young women; about 20 per cent of those with an eating disorder are male. Among adolescent girls, the estimated rate for eating disorders (18 per cent) is twice that of obesity (nine per cent.)

Katherine Dines’s decision to talk publicly about anorexia came as she exerted control over her own eating disorder after years of anguish and pain. “I want other people to have the chance to avoid stuff like that,” she says.

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